2326 HIGHLAND AVE 2018-05-17 - Laserfiche WebLink

_ECTRICAL PERMIT A. ' 'LICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECTADDRESS: � �q BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: �SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑ YES ❑ NO ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: Lo ,j� / -� � � / G�, � � O -� CONTACT INFORMATION OWNER NAME: �q,yy� � /(/ TENANT NAME(If Commercial): OWNER MAILING ADDRESS: srREET 7 6 r� I �C � CITY � STATE �� ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: srReer CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): _ _ _ _ PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: AGREEMENT. T hereby certify that I have read and examined this application and know the same fo be fnre and correct. AIl provisions of laws and ordinances governrng this type of work will be completed whether specified herein or not. The granfing of a permif does not presume fo give authorify fo violate or cancel the provisions of any other sfate or /oca/law regulating construction or the performance of consfruction. That 1 am authorized by the owner of thrs properfy to perform the work for whrch application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE � ��'�''��-'� o�o � _/ F PERMIT# �y 1 -� -�6 E4 � � � � (�� orized Agent Signature Date (Revised 10/12/2015)